Spectrum: Local Antimicrobial Stewardship, for Markham Stouffville Hospital

Haemophilus influenza type b (Neonates)

Duration of Therapy

7 Days

If β-lactamase Positive

Cefotaxime

Note:

Cefotaxime used instead of Ceftriaxone due to:

  • Risk of bilirubin encephalopathy in neonates or preterm infants less than 1 month corrected age

  • Interaction with calcium-containing IV infusions, including TPN in neonates and preterm infants less than 1 month corrected age

0-7 days

Less than 2 kg:
50 mg/kg IV/IM q12h

Greater than 2 kg:
50 mg/kg IV/IM q8h-q12h

8-28 days

Less than 1.2 kg:
50 mg/kg IV/IM q12h

Between 1.2-2 kg:
50 mg/kg IV/IM q8h

Greater than 2 kg:
50 mg/kg IV/IM q6h-q8h

If β-lactamase Negative

Ampicillin

0-7 Days
67 mg/kg IV q8h

8-28 Days
75 mg/kg IV q6h

OR

If Penicillin Allergy

Cefotaxime

Note:

Cefotaxime used instead of Ceftriaxone due to:

  • Risk of bilirubin encephalopathy in neonates or preterm infants less than 1 month corrected age

  • Interaction with calcium-containing IV infusions, including TPN in neonates and preterm infants less than 1 month corrected age

0-7 days

Less than 2 kg:
50 mg/kg IV/IM q12h

Greater than 2 kg:
50 mg/kg IV/IM q8h-q12h

8-28 days

Less than 1.2 kg:
50 mg/kg IV/IM q12h

Between 1.2-2 kg:
50 mg/kg IV/IM q8h

Greater than 2 kg:
50 mg/kg IV/IM q6h-q8h

Penicillin/Beta-lactam Allergy

If the patient has a true history of IgE mediated penicillin or beta-lactam allergy, the risks versus benefit of empiric treatment of suspected meningitis with appropriate antimicrobials should be discussed.

Refer to Beta-lactam allergy algorithm